5-羥色胺受體

5-羥色胺受體(5-hydroxy trptamine),一種吲哚衍生物。分子式C10H12N2O,普遍存在於動植物組織中。色氨酸經色氨酸羥化酶催化首先成5-羥色氨酸,再經5-羥色氨酸脫羥酶催化成5-羥色胺。

5-羥色胺受體(5-hydroxy trptamine),一種吲哚衍生物。分子式C10H12N2O,普遍存在於動植物組織中。色氨酸經色氨酸羥化酶催化首先成5-羥色氨酸,再經5-羥色氨酸脫羥酶催化成5-羥色胺。

簡介

5-羥色胺最早是從血清中發現的,又名血清素,廣泛存在於哺乳動物組織中,特別在大腦皮層及神經突觸內含量很高,它也是一種抑制性神經遞質。在外周組織,5-羥色胺是一種強血管收縮劑平滑肌收縮刺激劑
在體內,5-羥色胺在腦組織中的濃度較高,它是調節神經活動的一種重要物質。有些肌體組織當受到某些藥物作用時,可以釋放出5-羥色胺。
作為活性物質,約90%合成和分布於腸嗜鉻細胞,通常與ATP等物質一起儲存於細胞顆粒內,並被血小板攝取和儲存,儲存量約占全身的8%。5-HT作為神經遞質,主要分布於松果體下丘腦,可能參與痛覺、睡眠和體溫等生理功能的調節。中樞神經系統5-HT含量及功能異常可能與精神病與偏頭痛等多種疾病的發病有關。
5-HT必須通過相應受體的介導才能產生作用。5-HT受體分型複雜,已發現5-HT受體亞型。5-HT通過激活不同的5-HT受體亞型,可具有不同的藥理作用,但5-HT本身尚無臨床套用價值。

1.5-HT2A受體:5-HT2A受體基因定位於第13號染色體q14-21區,在嗅球、海馬、額葉皮質和梨狀內嗅皮質中密集分布。一些研究表明,精神分裂症患者腦額葉皮質5-HT2A受體的數目減少。非典型抗精神病藥如氯氮平、利培酮等對5-HT2A受體的阻滯作用強於對D2受體的阻滯。

對5-HT2A受體多態性與抗精神病藥反應的相關性的研究很多,但結果很不一致。Arranz等[16]報導5-HT2A受體編碼區 t102C多態性與精神分裂症有關,且與對氯氮平的反應有關。對氯氮平反應良好者的C102/C102純合子基因型的頻率低於無反應者,而T102/T102純合子頻率則高於無反應者。他們還發現,5-HT2A受體啟動子區域G-1438A和編碼區His452Tyr多態性也與對氯氮平的反應有關,對氯氮平治療無反應者的G-1438等位基因純合子頻率和Tyr452等位基因頻率均高於有反應者[17]。Malhotra等[18]的研究則未發現這些關係而Masellis等[19]的研究則發現T102C 和G-1438A多態性二者之間完全連鎖不平衡,但均與對氯氮平的反應無關,his452tyr多態性則與對氯氮平的反應有關。

2.5-HT2C受體:5-HT2C受體基因定位於X染色體q24區,分布於脈絡膜叢、前嗅核、梨狀區內嗅皮質、紋狀體及杏仁核中。5-HT2C受體可能含有非典型抗精神病藥如氯氮平的作用位點。

在5-HT2C受體基因編碼區第68位的鳥嘌呤被胞嘧啶替換,使受體蛋白23位半胱氨酸被絲氨酸替代,形成cys23ser多態性。Sodhi等[20]未發現此基因的多態性與精神分裂症有關聯,但報導90%的對氯氮平有反應的患者有1個或2個ser23等位基因,而在無此等位基因的患者中對氯氮平有反應者僅占59%,表明這個突變可預測對氯氮平的良好反應。Masellis等[19]則認為5-HT2C的cys23ser多態性與對氯氮平的反應無關。

3. 5-HT6受體:5-HT6受體基因定位於第1號染色體p35-36區,在人腦尾狀核中表達最多,在紋狀體中也大量表達。非典型抗精神病藥如氯氮平、利培酮等對5-HT6受體有很高的親和力,因此5-HT6介導的神經傳導可能在它們對精神分裂症的治療中發揮作用。

參考文獻

1,陸林,黃明生.DA受體亞型及其基因調控.國外醫學精神病學分冊,1997,24:202-204.

2,Chen CH, Wei FC, Koong FJ, et al. Association of TaqI A polymorphism of dopamine D2 receptor gene and tardive dyskinesia in schizophrenia. biol Psychiatry, 1997 ,41: 827-829.

3,Ohara K, Nagai M, Tani K, et al. Functional polymorphism of -141C Ins/Del in the dopamine D2 receptor gene promoter and schizophrenia. psychiatry Res,1998,81: 117-123.

4,Arranz MJ, Li T, Munro J, et al. Lack of association between a polymorphism in the promoter region of the dopamine-2 receptor gene and clozapine response. Pharmacogenetics, 1998,8: 481-484.

5,Joyce JN, Gurevich EV. D3 receptors and the actions of neuroleptics in the ventral striatopallidal system of Schizophrenics. Ann N Y acad Sci,1999, 877:595-613.

6,Shaikh S, Collier DA, Sham PC, et al. Allelic association between a ser-9-Gly polymorphism in the dopamine D3 receptor gene and schizophrenia. Hum Genet, 1996,97: 714-719.

7,Mant R, Williams J, Asherson P, et al. Relationship between homozygosity at the dopamine D3 receptor gene and schizophrenia. Am J Med genet,1994,54:21-26.

8,Steen VM, Lovlie R, MacEwan T, et al. Dopamine D3-receptor gene variant and susceptibility to tardive dyskinesia in schizophrenic patients. mol Psychiatry, 1997,2: 139-145.

9,Malhotra K, Goldman D, Buchanan RW, et al. The dopamine D3 receptor (DRD3) Ser9Gly polymorphism and schizophrenia: a haplotype relative risk study and association with clozapine response. Mol Psychiatry,1998,3: 72-75.

10,Chen CH,Liu MY, Wei FC, et al. Further evidence of no association between Ser9Gly polymorphism of dopamine D3 receptor gene and schizophrenia. Am J Med Genet,1997,74: 40-43.

11,Hong CJ, Lee YL, Sim CB, et al. Dopamine D4 receptor variants in chinese sporadic and familial schizophrenics. Am J Med Genet,1997, 74: 412-415.

12,Cohen BM, Ennulat DJ, Centorrino F, et al. Polymorphisms of the dopamine D4 receptor and response to antipsychotic drugs. Psychopharmacology Berl,1999 ,141:6-10.

13,Hwu HG, Hong CJ, Lee YL, et al. Dopamine D4 receptor gene polymorphisms and neuroleptic response in schizophrenia. Biol psychiatry,1998,44: 483-487.

14,Kohn Y,Ebstein RP, Heresco LU, et al. Dopamine D4 receptor gene polymorphisms: relation to ethnicity, no association with schizophrenia and response to clozapine in Israeli subjects. Eur Neuro psychopharmacol,1997, 7:39-43.

15,雷艷青,郭田生.5-HT在精神分裂症病理生理及其治療中的作用.國外醫學精神病學分冊,1998,25:95-97.

16,Arranz M, Collier D, Sodhi M ,et al. Association between clozapine response and allelic variation in 5-HT2A receptor gene. Lancet,1995,346: 281-282.

17,Arranz MJ, Munro J, Owen MJ, et al. Evidence for association between polymorphisms in the promoter and coding regions of the 5-HT2A receptor gene and response to clozapine. Mol Psychiatry,1998,3: 61-66.

18,Malhotra AK, Goldman D, Ozaki N, et al. Lack of association between polymorphisms in the 5-HT2A receptor gene and the antipsychotic response to clozapine. Am J Psychiatry,1996,153: 1092-1094.

19,Masellis M, Basile V, Meltzer HY, et al. Serotonin subtype 2 receptor gens and clinical response to clozapine in schizophrenia patients. neuropsychopharmacology, 1998,19:123-132.

20,Sodhi MS, Arranz MJ, Curtis D, et al. Association between clozapine response and allelic variation in the 5-HT2C receptor gene. neuroreport,1995 ,7: 169-172.

21,Shinkai T, Ohmori O, Kojima H, et al. Association study of the 5-HT6 receptor gene in schizophrenia. Am J Med Genet,1999,88: 120-122 .

22,Yu YW, Tsai SJ, Lin CH, et al. Serotonin-6 receptor variant (C267T) and clinical response to clozapine. Neuroreport,1999,10: 1231-1233.

23,Kohen R, Metcalf MA, Khan N, et al. Cloning, characterization, and chromosomal localization of a human 5-HT6 serotonin receptor. J neurochem, 1996,66:47-56.

24,《中華神經科雜誌2000年第33卷第3期》侯靜 徐貴雲 馬崔 (廣州市精神病醫院精神科)

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